Ellis County in shortage area
By Calen Moore
KCUR
DODGE CITY, Kansas— Footsteps and excited chatter of medical students from the Kansas College of Osteopathic Medicine fill the CommonSpirit hospital in Dodge City.
Fitted with white lab coats and scrubs bearing the Wichita medical school’s logo, they make their rounds touring the facility.
“I really like the vibe of this place. It’s pretty upbeat compared to the other city hospitals,” one says.
“Everyone is really busy. A lot of rooms are full,” another observes.
The students are part of a program that immerses them in rural areas, specifically in southwest Kansas, to let them shadow health care professionals. Officials from the program hope this will encourage more future physicians to consider practicing in western Kansas, where health care facilities are regularly understaffed.
Southwest Kansas had seen a shortage of health care professionals even before the COVID-19 pandemic. The region is hours away from an urban center and the amenities that come with it. And some hospitals don’t have the finances to pay employee wages or bonuses that can compete with other places.
The isolation and lack of incentives make it difficult for people like Chris Cervantes, who recruits physicians for CommonSpirit in Dodge City, Garden City and Ulysses.
“All the health care challenges are a little more extreme when you come to rural America,” Cervantes said.
It’s not uncommon for patients in rural areas to make a three-hour trip to see a specialist on a regular basis, he said. Or they might change doctors every couple of years, which can make it hard for them to trust their health care providers, he said.
“You might have a pediatrician for a couple of years, then your son or daughter turns 3 or 4, then you got to find a new pediatrician because there's no providers that are staying for the long haul,” Cervantes said.
Unique challenges and solutions
This problem echoes the plight of most Kansas counties, over 70% of which are experiencing a physician or nurse shortage, according to the Rural Health Information Hub.
That’s why last year the Kansas Health Science University and the Kansas College of Osteopathic Medicine in Wichita launched a joint program that would place medical students in these rural areas to relieve the shortages, while providing opportunities for medical student rotations.
Medical students currently in the program recently shadowed professionals in Dodge City for a day and then rounded out the trip in Garden City the following week.
Another layer that highlights the needs of southwest Kansans is the large Latino population present in the region. The most populated towns in this corner of the state are majority Latino, and they are three times less likely to have health insurance.
For these Kansans, it’s not just structural barriers that make it hard to receive the health care they need. Geovannie Gone, executive director of the Immunize Kansas Coalition, said at a Kansas Health Institute forum earlier this summer that there are also cultural barriers, given that the immigrant experience relies heavily on caring for their own and relying on home remedies.
But Cervantes said the region’s unique demographics may be the key to new recruitment strategies for physicians and nurses.
"You're going to get exposed to things you won't get exposed to in the larger areas,” Cervantes said.
This strategy has already proven to help even smaller communities like Lakin, 30 minutes west of Garden City, from closing its hospital, a fate that could await 56% of rural Kansas hospitals.
The Kearny County Hospital leaned into its diversity as a strategy to attract young physicians who wanted to deliver babies in less urban areas. They could do that right in western Kansas, where more than 20 languages are spoken in the Garden City school district, and agribusiness attracts immigrants and refugees.
The Kearny County Hospital went from delivering 187 babies in 2014 to 327 in 2017, Politico Magazine reported. In five years, it had become the county’s largest employer.
Workload and opportunities in rural Kansas
These opportunities sound especially interesting to medical students like Dina Suasnabar, who is originally from Peru.
“One of the reasons I went into medicine is because there aren't a lot of physicians that are one, Hispanic, and two, Spanish speaking,” Suasnabar said.
Suasnabar spent her day in Dodge City shadowing the hospital’s intensive care unit and visiting some of the newborns.
She pointed out the need for physicians to be “jacks of all trades” in rural Kansas because of the lack of specialists. Primary care doctors are sometimes the first or only line of support for rural Kansans.
“Back in California, you just pass off the patient, like you do the initial intake, you pass it on, but here you're doing more, so I think you're able to learn more,” Suasnabar said.
Cervantes said he hopes the program can add to the strategies in place to expand health care in rural Kansas.
“Providers want to know why they should move into an isolated area … and the different benefits that we can provide to these people,” Cervantes said.